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目的探讨肺特异性 X 蛋白基因检测对肺癌骨髓微转移的诊断价值。方法用荧光定量逆转录(RT)-PCR 法检测51例肺癌、13例肺外肿瘤(乳腺癌4例、胃癌6例、肝癌3例)、22例良性疾病(结核性脑炎4例、伤寒2例、流行性脑炎3例、再生障碍性贫血6例、粒细胞缺乏症7例)患者术前骨髓标本中 LUNX mRNA,并对各组检测结果进行比较分析。结果肺癌患者骨髓 LUNXmRNA 表达阳性率及中位拷贝数分别为58.8%(30/51)、35拷贝/ml;其他疾病组则均为0,其组间差异均有统计学意义(x~2=11.12,U_c=3.7329,均 P<0.01)。荧光定量 RT-PCR 法检测肺癌微转移患者骨髓 LUNX mRNA 表达的特异性为100%;而且肺癌患者骨髓标本 LUNX mRNA 表达与组织病理学类型、细胞分化程度及 TNM 分期均呈正相关(均 P<0.05)。结论 LUNX mRNA 是诊断肺癌骨髓微转移特异性较高的分子标志。
Objective To investigate the diagnostic value of lung specific X protein in the diagnosis of bone marrow micrometastasis in lung cancer. Methods 51 cases of lung cancer, 13 cases of extrapulmonary tumors (4 cases of breast cancer, 6 cases of gastric cancer, 3 cases of liver cancer) and 22 cases of benign disease (4 cases of tuberculous encephalitis, typhoid fever 2 cases, 3 cases of epidemic encephalitis, 6 cases of aplastic anemia, 7 cases of agranulocytosis) in patients with preoperative LUNX mRNA in bone marrow specimens, and comparative analysis of test results for each group. Results The positive rate and median copy number of LUNXmRNA in bone marrow of patients with lung cancer were 58.8% (30/51) and 35 copies / ml, respectively. The other disease groups were all 0, the difference between the two groups was statistically significant (x 2 = 11.12, U_c = 3.7329, all P <0.01). The specificity of LUNX mRNA in bone marrow of patients with lung cancer with micrometastasis was 100% by fluorescence quantitative RT-PCR. The expression of LUNX mRNA in bone marrow specimens of lung cancer patients was positively correlated with histopathological types, cell differentiation and TNM stage (all P <0.05 ). Conclusion LUNX mRNA is a molecular marker for diagnosis of bone marrow micrometastasis in lung cancer.